Infection control

Hello Everyone,

VRE as with other bugs in the hospital are often caught while people are in hospital. The hospital often screens for VRE when patients are transferred out of ICU. They undergo numerous tests to confirm they are VRE negative. If anyone of the tests come back positive the patient is isolated and flagged. Quite often these bugs are in the hospital and therefore if a person contracts the virus it might not be their fault as little can be done to avoid this transmission. The longer a patient remains in hospital the greater their chance is of acquiring the virus.

Infection control protocol is to isolate them in a single room and anyone that comes in contact with the patient needs to have gloves and a gown on, if you are dealing with fluids a face mask is required. People often become nervous and cautious around these flagged patients.

I was given a new patient. I checked his file and it said VRE positive. My first thought was oh no…time to gown and glove up not my most enjoyable part of my day. Yes I know we have had presentations on how to protect our self and proper application of infection control however I still worry about the transmission and how to avoid it. Everyone who has ever had to glove and gown knows how hot, uncomfortable and worried you become when you are in contact with the patient. It tends to impact on the quality of your treatment. Until today all my thoughts and concerns have been to protect myself, I have failed to think of how the patient feels when they are diagnosed as VRE positive.

As I continue to read through my new patient’s notes it states that he has become very depressed/down from being in this room alone and due to being flagged. The notes report he has asked to leave and not have a single room. But his request was obviously denied as he would put the rest of the ward at risk. Despite this fact he has taken matters into his own hands and now sits out in the hallway and forcefully refuses to return to the room. As you can tell the nurses have a tricky issue on their hands. The patient is making scenes and refusing to return to the room but at the same time he is violating the infection control protocol. Plus his depression and mental state has become a large concern for the nurses as well. “He feels like he is going crazy in this hole”. The nurses are responsible for his well being as well as the ward’s health. This situation has forced the head nurse to contact the infection control to see what the hospitals options are. The infection control people said with him just sitting in the hallway he would not increase the risk of contamination.
My question is then why are all the protocols made when they have decided to allow him to sit out in the hallway all day as it won’t cause the virus to spread?

In the hospital the protocols are often not consistent between members of the ward. This lack of consistency and allowing patients to be walked on the ward seems to send mix messages with regards to the severity of infection control.

Perhaps there should be a ward that is specific to different infection controls? Might this decrease the risk for other patients, allow more consistent delivery of protocols as nurses on that ward would be dealing with cases more often and therefore become more efficient and confident with the infection control protocol. An option like this might reduce the risk of mental state and depression emerging in these patients due to the segregation they experience on other wards.
It’s a tricky one any thoughts?

Thanks have a great weekend everyone :).
dani